Mindfulness-based cancer recovery and Tai Chi/Qigong were associated with improvements in fatigue and pain interference among distressed individuals who had completed cancer treatment, with Tai Chi/Qigong also improving sleep quality, according to findings from the Mindfulness and Tai Chi for Cancer Health (MATCH) trial reported by Ma et al in the Journal of Clinical Oncology.
Study Details
The MATCH trial included 587 participants who had completed primary cancer treatment and were experiencing at least moderate distress. The mean age was 60.7 years, and 75% of participants were women. Breast cancer was the most common previous diagnosis (40.7%), followed by prostate (11.2%), gastrointestinal (9.7%), gynecologic (7.5%), lung (4.6%), and skin cancers (4.6%). Approximately half had stage 0 to II disease.
Participants could choose mindfulness-based cancer recovery or Tai Chi/Qigong or elect to be randomly assigned to one of the interventions. Overall, 376 participants (64.1%) selected their intervention, whereas 211 (35.9%) elected random assignment. Within these groups, participants were further randomly assigned 2:1 to begin the intervention immediately or join a waitlist control group.
Mindfulness-based cancer recovery consisted of a 9-week program incorporating meditation, Hatha yoga, group discussion, and daily home practice. Tai Chi/Qigong was delivered over 11 weeks and incorporated flowing movements, breath awareness, focused attention, body awareness, and imagery. The programs were designed to provide equal contact time. Outcomes included sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI), fatigue measured by the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F), and pain severity and interference measured by the Brief Pain Inventory.
Key Results
In fully adjusted longitudinal analyses, Tai Chi/Qigong significantly improved sleep quality compared with the waitlist control, with a 1.90-point reduction in PSQI score (95% confidence interval [CI] = –3.18 to –0.62, P = .004). Mindfulness-based cancer recovery also reduced PSQI scores, but the difference from the control group was not statistically significant.
Both interventions significantly improved fatigue after adjustment for age, sex, cancer stage, and preference status. The improvement was 3.66 points with mindfulness-based cancer recovery (95% CI = 0.25–7.08, P = .036) and 3.42 points with Tai Chi/Qigong (95% CI = 0.10–6.73, P = .043). The investigators noted that a 3- to 4-point change on the FACIT-F is considered a minimal clinically important difference.
Neither intervention significantly reduced pain severity. However, pain interference decreased significantly with both mindfulness-based cancer recovery (β = –1.10, 95% CI = –2.09 to –0.11, P = .029) and Tai Chi/Qigong (β = –1.52, 95% CI = –2.49 to –0.55, P = .002). Differences between mindfulness-based cancer recovery and Tai Chi/Qigong were not statistically significant for any of the assessed outcomes.
The investigators concluded: “Compared with waitlist controls, [mindfulness-based cancer recovery] and [Tai Chi/Qigong] both improved fatigue and pain interference at post-intervention, and [Tai Chi/Qigong] also improved sleep quality. Correlations across outcomes highlight the importance of addressing clusters of cancer symptoms within a whole-person health framework.”
Linda E. Carlson, PhD, of the Department of Oncology, University of Calgary, Calgary, AB, Canada, is the corresponding author for the Journal of Clinical Oncology article.
DISCLOSURE: The study was supported by the Lotte & John Hecht Memorial Foundation. For full disclosures of the study authors, visit ascopubs.org.
